Etiology Classification And Therapeutic Effect Observation Of 430 Cases Of Interstitial Lung Disease

The interstitial lung disease is a group of disease, which have pathological changes not only in pulmonary alveolus wall, but also includes the pulmonary alveolus peritonsillar tissue and neighboring structural support. On clinical causes, the cause of the disease is too many, but its accurate occurrence mechanism is not completely known. Once, people thought ILD is a chronic illness, which progresses gradually, and has the respiratory failure finally. The course is stable. But on clinical, the ILD patients often suddenly present the uncertain acute excacerbation in the relative stabilization period, which causes the condition aggravate and make the lung injury, the serious patients may cause ALI/ARDS, have the respiratory failure, even dies. In recent yearss,serious along with the air pollution, smoking, using upholster material factors and so on, caused ILD incidence rate to assume year by year, the research of the etiology and treatment is growing day by day.This research retrospects 430 examples of ILD,which had a acute excacerbation, in department of Respiratory Medicine of The Second Hospital of Jilin University from January 2005 to February 2010, and retrospects related literature, in order to explore its etiology classification and clinical therapeutic effect, which will provide the basis for ILD diagnosis and therapy.All the patients were characterized by the clinical materials. The acute excacerbated patients,which has ILD before, displayed new and activity dyspnea or the original syspnea incresd in short-time (<30 days).At the same time, almost all the patients have fever,courgh and expectoration. The diagnosis of acute viral pneumonia is according to the severe pneumonia diagnosis. Some patients had foundation diseases, but the diseases are in the stabilization period during the process, and rule out other complicating diseases or drugs may cause ILD at the same time.Results:â‘ The causes of ILD are ususally complex and most of them are unknown, idiopathic interstitial pneumonia in unknown etiology with a higher incidence,and Idiopathic Pulmonary Fibrosis, which has a higher incidence rate. Followed by ILD secondary to connective tissue disease. And secondary to rheumatoid arthritis is mor common. In our research,378 examples, account for 87.91%, didn't know the exact cause. And 350 examples (92.59%) are IIP.27 examples are CTD-ILD, which account for 7.14%, the RA caused 13 example, accounts for 48.15%. Acute viral pneumonia can also cause acute interstitial lung injury, and for its specificity, the poor prognosis in patients will induce a more serious condition. There are 51 examples in the research, which has 11 cases died, the death rate is 21.57%.â‘¡The glucocorticoid is regarded to be the most effective medicine of ILD and the acute excacerbation of ILD therapeutic drug at present. In the 430 examples,401 examples(remove the 27 cases of acute viral pneumonia) apply GC, the rate is 93.26%, which shows that, GC has become a indispensable drug in our hospital treatment. After statistical analysis, the clinical effect of the steroid pulse therapy and the conventional dose of GC therapy shows no significant difference, which shows similar efficacy between the two. For in acute alveolitis and pulmonary interstitial inflammation in patients with ILD, early to moderate the impact of GC therapy can reduce the inflammatory response significantly and improve the clinical symptoms. So GC therapy should be individualized.â‘¢The immunosuppressant is also effective to ILD, expecially to CTD-ILD.25 exmaples, according to different primary disease and illness, give the appropriate medication. Total effective rate of 76%. But for the limited sample size, unknown pathological type, CTD disease status and so on, did't get a statistically significant difference.â‘£Ulinastatin has a widespread clinical practice prospect, because it does not have the immunogenic, and has many kinds of different physiological actions. Some researchs demonstrated that, using GC and Ulinastatin at the same time had a more marked protective function in lung. Though the causes of ILD are various, the clinical effects of the UTI are the same. But for the acute viral pneumonia with acute exudative, the UTI has a significant role to improve the image.Conclusion:1 The cause of ILD is complex, most causes are unknown.idiopathic interstitial pneumonia is more common in our department. Next is CTD-ILD. and RA causes the secondary ILD is more common.2 Glucocorticoids are the basis drug for acute ILD in our hospital.3 Immunosuppressant is first-line drug treatment in our hospital for CTD-ILD therapy.. 4 Ulinastatin is an effective lung protective agent, expecially to the acute viral pneumonia patients, it can make favorable prognosis in early stage.